Mission Community Hospital
14850 Roscoe Blvd, Panorama City, CA 91402 · Acute care hospital
These are Mission Community Hospital's own posted figures from its standard-charges file dated September 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
225 of the services we track have a posted price here; 119 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.
Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Critical care, first 30 to 74 minutes CPT 99291 | $6,088.51 | $6,088.51 | $1,118.46 – $5,479.66 |
| Emergency room visit, level 1 (minor) CPT 99281 | $291.50 | $291.50 | $53.55 – $262.35 |
| Emergency room visit, level 2 CPT 99282 | $754.09 | $754.09 | $138.53 – $678.68 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,679.23 | $1,679.23 | $308.47 – $1,511.31 |
| Emergency room visit, level 4 CPT 99284 | $2,791.16 | $2,791.16 | $512.74 – $2,512.04 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $4,552.42 | $4,552.42 | $836.28 – $4,097.18 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | not posted | $2,074.00 – $10,074.00 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $775.03 | $775.03 | $142.37 – $697.53 |
| New patient office visit, about 30 minutes CPT 99203 | $436.18 | $436.18 | $80.13 – $392.56 |
| New patient office visit, about 45 minutes CPT 99204 | $523.41 | $523.41 | $153.15 – $153.15 |
| New patient office visit, about 60 minutes CPT 99205 | $610.64 | $610.64 | $178.67 – $178.67 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $348.94 | $348.94 | $64.10 – $314.05 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $544.61 | $544.61 | $100.04 – $490.15 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $523.41 | $523.41 | $153.15 – $153.15 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $610.64 | $610.64 | $180.87 – $180.87 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $261.71 | $261.71 | $77.52 – $77.52 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $66.93 | $66.93 | $12.30 – $60.24 |
| Abdominal X-ray, 1 view CPT 74018 | $477.34 | $477.34 | $87.69 – $429.61 |
| Ankle X-ray, 3 or more views CPT 73610 | $530.19 | $530.19 | $97.40 – $477.17 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $283.60 | $283.60 | $52.10 – $255.24 |
| Breast ultrasound, one breast, complete CPT 76641 | $463.24 | $463.24 | $85.10 – $416.92 |
| Breast ultrasound, one breast, limited CPT 76642 | $1,306.97 | $1,306.97 | $240.09 – $1,176.27 |
| Chest X-ray, 1 view CPT 71045 | $556.62 | $556.62 | $102.25 – $500.96 |
| Chest X-ray, 2 views CPT 71046 | $655.25 | $655.25 | $120.37 – $589.73 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $6,700.05 | $6,700.05 | $1,230.80 – $6,030.05 |
| CT angiogram of the head CPT 70496 | $6,700.05 | $6,700.05 | $1,230.80 – $6,030.05 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $10,352.57 | $10,352.57 | $1,901.77 – $9,317.31 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $8,265.69 | $8,265.69 | $1,518.41 – $7,439.12 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $8,326.55 | $8,326.55 | $1,529.59 – $7,493.89 |
| CT scan of the abdomen, without contrast CPT 74150 | $4,129.97 | $4,129.97 | $758.68 – $3,716.97 |
| CT scan of the chest, with contrast CPT 71260 | $4,936.58 | $4,936.58 | $906.85 – $4,442.92 |
| CT scan of the chest, without contrast CPT 71250 | $4,129.97 | $4,129.97 | $758.68 – $3,716.97 |
| CT scan of the head, without contrast CPT 70450 | $4,276.47 | $4,276.47 | $785.59 – $3,848.82 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $4,609.39 | $4,609.39 | $846.74 – $4,148.45 |
| CT scan of the pelvis, with contrast CPT 72193 | $5,341.78 | $5,341.78 | $981.28 – $4,807.60 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $4,276.47 | $4,276.47 | $785.59 – $3,848.82 |
| Diagnostic mammogram, both breasts CPT 77066 | $484.38 | $484.38 | $88.98 – $435.94 |
| Diagnostic mammogram, one breast CPT 77065 | $405.13 | $405.13 | $74.42 – $364.62 |
| Foot X-ray, 3 or more views CPT 73630 | $530.19 | $530.19 | $97.40 – $477.17 |
| Hand X-ray, 3 or more views CPT 73130 | $530.19 | $530.19 | $97.40 – $477.17 |
| Knee X-ray, 3 views CPT 73562 | $583.03 | $583.03 | $107.10 – $524.73 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $2,680.78 | $2,680.78 | $794.05 – $794.05 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,745.70 | $1,745.70 | $320.69 – $1,571.13 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $479.11 | $479.11 | $88.01 – $431.20 |
| MRI of both breasts, without and with contrast CPT 77049 | not posted | $635.92 – $635.92 | |
| MRI of the abdomen, without and with contrast CPT 74183 | $8,453.10 | $8,453.10 | $1,552.83 – $7,607.79 |
| MRI of the brain, without and with contrast CPT 70553 | $8,180.09 | $8,180.09 | $1,502.68 – $7,362.08 |
| MRI of the brain, without contrast CPT 70551 | $5,781.01 | $5,781.01 | $1,061.97 – $5,202.91 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $5,847.94 | $5,847.94 | $1,074.27 – $5,263.15 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $5,913.12 | $5,913.12 | $1,086.24 – $5,321.81 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $5,913.12 | $5,913.12 | $1,086.24 – $5,321.81 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $5,913.12 | $5,913.12 | $1,086.24 – $5,321.81 |
| MRI of the pelvis, without and with contrast CPT 72197 | $8,366.79 | $8,366.79 | $1,536.98 – $7,530.11 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $5,497.42 | $5,497.42 | $1,009.88 – $4,947.68 |
| Neck X-ray, 2 or 3 views CPT 72040 | $982.88 | $982.88 | $180.56 – $884.59 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,551.81 | $1,551.81 | $285.07 – $1,396.63 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $1,441.98 | $1,441.98 | $264.89 – $1,297.78 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $660.11 | $660.11 | $121.26 – $594.10 |
| Screening mammogram, both breasts CPT 77067 | $473.83 | $473.83 | $87.04 – $426.45 |
| Shoulder X-ray, 2 or more views CPT 73030 | $510.82 | $510.82 | $93.84 – $459.74 |
| Transvaginal pregnancy ultrasound CPT 76817 | $1,114.98 | $1,114.98 | $245.18 – $245.18 |
| Transvaginal ultrasound CPT 76830 | $1,210.12 | $1,210.12 | $222.30 – $1,089.11 |
| Ultrasound of the abdomen, complete CPT 76700 | $2,102.08 | $2,102.08 | $386.15 – $1,891.87 |
| Ultrasound of the neck or thyroid CPT 76536 | $1,243.56 | $1,243.56 | $228.44 – $1,119.20 |
| Wrist X-ray, 3 or more views CPT 73110 | $634.12 | $634.12 | $116.49 – $570.71 |
| X-ray of the lower back, 4 or more views CPT 72110 | $841.97 | $841.97 | $154.67 – $757.77 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | not posted | $8.46 – $8.46 | |
| Blood culture CPT 87040 | not posted | $10.32 – $10.32 | |
| Blood draw (venipuncture) CPT 36415 | $71.42 | $71.42 | $13.12 – $64.28 |
| BNP test (heart failure) CPT 83880 | $409.41 | $409.41 | $39.26 – $39.26 |
| C-reactive protein (CRP) test CPT 86140 | not posted | $5.18 – $5.18 | |
| Chlamydia test (DNA/NAAT) CPT 87491 | not posted | $31.78 – $49.13 | |
| Complete blood count (CBC) with differential CPT 85025 | not posted | $7.77 – $7.77 | |
| Complete blood count (CBC), automated CPT 85027 | $192.00 | $192.00 | $35.27 – $172.80 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $387.98 | $387.98 | $71.27 – $349.18 |
| COVID-19 PCR test CPT 87635 | not posted | $51.31 – $51.31 | |
| D-dimer test (blood clots) CPT 85379 | $303.09 | $303.09 | $10.18 – $10.18 |
| Drug screen, instrument chemistry CPT 80307 | $516.52 | $516.52 | $62.14 – $62.14 |
| Ferritin (iron stores) test CPT 82728 | not posted | $13.63 – $13.63 | |
| Free T4 (thyroid) test CPT 84439 | not posted | $9.02 – $9.02 | |
| General health panel (blood tests) CPT 80050 | not posted | $45.36 – $45.36 | |
| Glucose (blood sugar) test CPT 82947 | $84.89 | $84.89 | $3.93 – $3.93 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | not posted | $35.09 – $35.09 | |
| Hemoglobin A1c test CPT 83036 | $45.77 | $45.77 | $8.41 – $41.19 |
| Hepatitis C antibody test CPT 86803 | $57.19 | $57.19 | $10.51 – $51.47 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | not posted | $24.08 – $24.08 | |
| Iron test CPT 83540 | not posted | $6.47 – $6.47 | |
| Kidney function panel CPT 80069 | not posted | $8.68 – $8.68 | |
| Lipase test (pancreas) CPT 83690 | not posted | $6.89 – $6.89 | |
| Lipid panel, cholesterol and triglycerides CPT 80061 | not posted | $13.39 – $13.39 | |
| Liver function panel CPT 80076 | not posted | $8.17 – $8.17 | |
| Magnesium test CPT 83735 | $183.29 | $183.29 | $33.67 – $164.96 |
| Obstetric blood test panel CPT 80055 | not posted | $47.81 – $47.81 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $170.59 | $170.59 | $6.01 – $6.01 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | not posted | $15.05 – $15.05 | |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $142.02 | $142.02 | $26.09 – $127.82 |
| PSA (prostate specific antigen), free CPT 84154 | not posted | $18.39 – $18.39 | |
| PSA (prostate specific antigen), total CPT 84153 | not posted | $18.39 – $18.39 | |
| Rapid strep test CPT 87880 | $174.10 | $174.10 | $31.98 – $156.69 |
| Sed rate (ESR) test CPT 85652 | not posted | $2.70 – $2.70 | |
| TB skin test CPT 86580 | $43.64 | $43.64 | $24.67 – $24.67 |
| Thyroid stimulating hormone (TSH) CPT 84443 | not posted | $16.80 – $16.80 | |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | not posted | $49.76 – $49.76 | |
| Troponin test (heart damage) CPT 84484 | $251.69 | $251.69 | $46.24 – $226.52 |
| Urinalysis, automated, with microscope CPT 81001 | not posted | $3.17 – $3.17 | |
| Urinalysis, automated, without microscope CPT 81003 | $149.56 | $149.56 | $27.47 – $134.60 |
| Urinalysis, manual, with microscope CPT 81000 | not posted | $4.02 – $5.63 | |
| Urinalysis, manual, without microscope CPT 81002 | $137.30 | $137.30 | $25.22 – $123.57 |
| Urine culture, colony count CPT 87086 | not posted | $8.07 – $11.30 | |
| Urine pregnancy test CPT 81025 | $223.93 | $223.93 | $41.14 – $201.54 |
| Vitamin B12 test CPT 82607 | not posted | $15.08 – $15.08 | |
| Vitamin D test CPT 82306 | not posted | $29.60 – $29.60 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $2,775.03 | $2,775.03 | $821.96 – $821.96 |
| ECG tracing only (no interpretation) CPT 93005 | $408.47 | $408.47 | $119.52 – $119.52 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $4,264.40 | $4,264.40 | $783.37 – $3,837.96 |
| Left heart catheterization CPT 93452 | not posted | $19,301.00 – $19,301.00 | |
| Left heart catheterization with coronary angiogram CPT 93458 | not posted | $19,301.00 – $19,301.00 | |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $8,583.45 | $8,583.45 | $1,576.78 – $7,725.11 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $3,954.00 – $31,014.00 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $15,151.00 – $31,014.00 | |
| Breast biopsy with ultrasound guidance CPT 19083 | not posted | $3,676.00 – $10,074.00 | |
| Carpal tunnel release CPT 64721 | not posted | $2,894.00 – $14,309.00 | |
| Colonoscopy with biopsy CPT 45380 | not posted | $2,894.00 – $7,778.00 | |
| Colonoscopy with polyp removal (snare) CPT 45385 | not posted | $2,894.00 – $3,676.00 | |
| Colonoscopy, diagnostic CPT 45378 | not posted | $2,894.00 – $7,778.00 | |
| Colposcopy with biopsy CPT 57454 | not posted | $2,074.00 – $10,074.00 | |
| Cystoscopy (bladder scope) CPT 52000 | not posted | $2,293.00 – $4,317.00 | |
| Ear tubes, under general anesthesia CPT 69436 | not posted | $3,676.00 – $7,778.00 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | not posted | $2,692.00 – $10,074.00 | |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $15,151.00 – $31,014.00 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $31,014.00 – $31,014.00 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $31,014.00 – $31,014.00 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $4,950.00 – $5,445.00 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $9,094.00 – $15,151.00 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $4,950.00 – $5,445.00 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | not posted | $31,014.00 – $31,014.00 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | not posted | $9,094.00 – $18,367.00 | |
| Lower colon endoscopy with ultrasound CPT 45391 | not posted | $2,894.00 – $3,676.00 | |
| Nasal endoscopy, diagnostic CPT 31231 | not posted | $2,074.00 – $10,074.00 | |
| Prostate biopsy CPT 55700 | not posted | $2,894.00 – $3,676.00 | |
| Prostate removal, laparoscopic or robotic CPT 55866 | not posted | $37,185.00 – $37,185.00 | |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $2,800.00 – $4,950.00 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $14,789.00 – $31,014.00 | |
| Screening colonoscopy, average risk HCPCS G0121 | not posted | $2,692.00 – $4,317.00 | |
| Screening colonoscopy, high risk HCPCS G0105 | not posted | $2,692.00 – $4,317.00 | |
| Septoplasty (nasal septum repair) CPT 30520 | not posted | $8,457.00 – $9,094.00 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $2,074.00 – $3,954.00 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | not posted | $10,074.00 – $31,014.00 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | not posted | $3,954.00 – $14,309.00 | |
| Total hip replacement CPT 27130 | not posted | $62,226.00 – $62,226.00 | |
| Total knee replacement CPT 27447 | not posted | $62,226.00 – $62,226.00 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | not posted | $2,894.00 – $7,778.00 | |
| Upper endoscopy (EGD), diagnostic CPT 43235 | not posted | $2,293.00 – $7,778.00 | |
| Vasectomy CPT 55250 | not posted | $2,894.00 – $14,309.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| C-section delivery, routine care including prenatal and postpartum CPT 59510 | not posted | $10,074.00 – $10,074.00 | |
| Fetal non-stress test CPT 59025 | $338.64 | $338.64 | $99.09 – $99.09 |
| IUD insertion CPT 58300 | not posted | $2,074.00 – $10,074.00 | |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | not posted | $10,074.00 – $10,074.00 | |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | not posted | $2,550.00 – $2,800.00 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | not posted | $941.85 – $1,073.71 | |
| C-section, without complications MS-DRG 788 | not posted | $2,570.00 – $2,570.00 | |
| Chest pain MS-DRG 313 | not posted | $6,853.32 – $17,802.00 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $9,819.79 – $25,306.51 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $6,256.51 – $14,667.13 | |
| Fainting (syncope) MS-DRG 312 | not posted | $4,140.00 – $4,140.00 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $8,848.05 – $22,405.07 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $11,167.21 – $33,116.00 | |
| Heart failure, without complications MS-DRG 293 | not posted | $5,214.92 – $16,117.00 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $76,196.80 – $223,497.85 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $16,103.15 – $46,923.00 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,140.00 – $4,140.00 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $4,140.00 – $4,140.00 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $7,538.13 – $20,529.00 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $6,223.00 – $6,223.00 | |
| Normal newborn care MS-DRG 795 | not posted | $2,448.00 – $2,526.00 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $4,140.00 – $4,140.00 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $4,140.00 – $4,140.00 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $11,097.00 – $34,950.00 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $4,140.00 – $4,140.00 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $885.20 – $1,009.13 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $4,140.00 – $4,140.00 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $9,174.00 – $23,378.31 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $4,140.00 – $4,140.00 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $4,140.00 – $4,140.00 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $4,140.00 – $4,140.00 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $10,837.43 – $28,345.03 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $1,351.00 – $1,502.00 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $31,113.00 – $31,113.00 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $1,035.19 | $1,035.19 | $2,074.00 – $10,074.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | not posted | $2,293.00 – $4,317.00 | |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | not posted | $2,692.00 – $10,074.00 | |
| Lower back spinal injection (epidural), without imaging CPT 62322 | not posted | $2,692.00 – $10,074.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | not posted | $8,457.00 – $18,584.00 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | not posted | $2,692.00 – $2,894.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $743.61 | $743.61 | $217.58 – $217.58 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $773.28 | $773.28 | $1,190.00 – $1,190.00 |
| Sleep study with CPAP titration CPT 95811 | $4,974.85 | $4,974.85 | $1,190.00 – $1,190.00 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,936.44 | $4,936.44 | $1,190.00 – $1,190.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $464.32 | $464.32 | $135.86 – $135.86 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $146.93 | $146.93 | $26.99 – $132.24 |
| Physical therapy evaluation, low complexity CPT 97161 | $298.27 | $298.27 | $54.79 – $268.44 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $298.27 | $298.27 | $54.79 – $268.44 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $146.93 | $146.93 | $26.99 – $132.24 |
| Therapeutic activities, 15 minutes CPT 97530 | $154.28 | $154.28 | $28.34 – $138.85 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $436.38 | $436.38 | $80.16 – $392.74 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $83.79 | $83.79 | $24.82 – $24.82 |
| Group psychotherapy CPT 90853 | $518.44 | $518.44 | $95.24 – $466.60 |
| Psychiatric diagnostic evaluation CPT 90791 | $625.35 | $625.35 | $185.23 – $185.23 |
| Psychotherapy, 30 minutes CPT 90832 | $254.87 | $254.87 | $74.57 – $74.57 |
| Psychotherapy, 45 minutes CPT 90834 | $567.31 | $567.31 | $168.04 – $168.04 |
| Psychotherapy, 60 minutes CPT 90837 | $625.22 | $625.22 | $182.94 – $182.94 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $438.13 | $438.13 | $128.20 – $128.20 |
| IV hydration, each additional hour CPT 96361 | $189.40 | $189.40 | $56.10 – $56.10 |
| IV hydration, first hour CPT 96360 | $1,146.84 | $1,146.84 | $210.67 – $1,032.16 |
| IV push injection of a drug, first CPT 96374 | $478.27 | $478.27 | $139.94 – $139.94 |
| IV push injection, each additional drug CPT 96375 | $438.13 | $438.13 | $80.48 – $394.32 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $176.40 | $176.40 | $32.40 – $158.76 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $63.72 | $63.72 | $11.71 – $57.35 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $1,398.22 | $1,398.22 | $256.85 – $1,258.40 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $66.26 | $66.26 | $12.17 – $59.63 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $1,540.25 | $1,540.25 | $282.94 – $1,386.22 |
| Morphine injection, up to 10 mg HCPCS J2270 | $665.55 | $665.55 | $122.26 – $598.99 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $22.17 | $22.17 | $4.07 – $19.95 |
| Propofol injection, per 10 mg HCPCS J2704 | $413.69 | $413.69 | $75.99 – $372.32 |
| Saline IV solution, 1000 ml HCPCS J7030 | $114.26 | $114.26 | $20.99 – $102.83 |
Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.